Author of The Dark Secrets of SHTF Survival and the online course SHTF Survival Boot Camp
The medical field is one of my favorite fields of prepping, not only because it is my “field of work” for many years but also because it is very often misunderstood in prepping.
There are many reasons for that, one of the reasons is the fact that there are many other “cooler” topics for prepping. As a result, medical preparedness gets researched very superficial, and people prepare for it in a way that most of them want just to mark that as done and move on to other topics.
So as a foundation in medical prepping for SHTF think about a few things, for a start only.
“Help is on the way”
You know that sentence from the movies, books, documentaries and similar: “help is on the way?”
So you just need to “plug the hole”, keep the head of the wounded up, put wet tissue on his forehead or something similar until chopper for evacuation arrives, or paramedic unit or whatever.
Well, it will not work like that if the SHTF.
People often prepare for SHTF by storing weapons and ammo like they are expecting a full zombie apocalypse but at the same time, their first aid kits look like they are ordered them from China for 5.99 USD.
So you are expecting it is gonna be so bad that you need several different types of weapon and loads of ammo but you do not expect you are gonna have a medical emergency not more complicated than a blister?
If you preparing for bad stuff, then expect the bad stuff that comes with it.
If you preparing for a complete absence of the system why does your first aid kit cover (barely) only the time up to the moment when medical help arrives – medical help that will absolutely not exist in a full-scale SHTF event?
In a real SHTF event, YOU probably gonna be all the help available, both immediate and prolonged, with stuff that you have prepped and with the knowledge that you have, so choose what to have and how much to learn.
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Taking the online courses are the next best thing to getting over to Europe and studying with him personally.
- SHTF Survival Boot Camp teaches you both urban and wilderness survival skills, primitive first aid, and lessons about the violence that you’ll never forget.
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If you want the real deal from a legend who has lived through the SHTF, these are the online courses for you.[/page_section]
What is cool vs. what is needed
Next step should be just like with most preps, choosing what is cool or choosing what is really needed.
If you have the resources to cover both, sure why not, but keep in mind that “what is needed” comes before “what is cool”. And what is needed MORE comes even before that.
Here is one example.
You attended a trauma care course given by ex-combat medic.
It is a cool and good course. You’ll learn how to manage bleeding and trauma while under pressure. Instructors are gonna simulate pressure by loud and unexpected noises while you are trying to treat someone with a gunshot wound, maybe instructors will fire shots (blanks) to simulate combat or explosions, or flash lights at you while you are treating the patient, etc.
As I said it is good and cool course. I have been on courses like that, both as a combat medic instructor and a student.
But mostly instructors failed to acknowledge one big thing there: They are instructing you in the knowledge that they have based on their work and experience.
That means treating injured as a professional and as part of a big and powerful system (in this case, the whole army).
So there is system (chopper, ambulance or whatever) to pick wounded after your short treatment, and there are resources no matter how much you need (IVs, bandages, gauzes…) because the system is there.
So, as a result, you are training and learning to use medical knowledge, not in SHTF, but you are training to use it in normal times.
Again, it is good knowledge, and valuable, it can be used today in normal times, and in SHTF, but it is only a small (and “cool” ) part of it.
But you are preparing for a time where there is no system (because SHTF) you need first to learn different stuff (too)
Another example would be that you need to learn how to disinfect your home or latrine, or to learn how to treat a prolonged wound, wound that is infected, or to recognize and treat pneumonia.
So, think a bit outside of that “cool” box.
A good start is to prepare for stuff that you are expecting to see when SHTF.
Do you really expect you are only gonna treat gunshot wounds (until help arrives) or do you think it is gonna be much more about hygiene, infection, antibiotics, bad food, and water-induced conditions and similar?
“Buy this because it will save your life” does not mean too much until you research it and test it.
I think around 70 % of students coming to my courses with first aid kits that have stuff completely unopened and not tested.
And it is their first aid kit for SHTF.
So, to put it in a different way: would you buy a gun today that is gonna save your life when SHTF and put that gun packaged in original box (not tested, not fired from it) and store it in a locked cabinet for the day when SHTF?
I think (I hope) you would not.
So why you would do that with a first aid kit?
It saves lives too.
One of the reasons why nothing there is opened and tested is, “Oh but it is sterile! I do not want to open it and make it non-sterile!”
That bandage (gauze, field dressing, burn pad, or whatever) costs like a couple of dollars, it is nothing. Do you really want to find yourself in a situation where you scared to s**t and adrenalized so high that you think your heart will explode, and you need to bandage a wound and at that moment you opened a field dressing and realize that you do not have clue what goes where and what you are doing?
Every item in your first aid kit should have a clear reason to be there, needs to be absolutely and completely tested by you, and you should be confident in using it.
Just like you need to be positive how big recoil your gun has, and how fast you can reload it, it is similar with first aid kits.
Actually, it is even stranger because people often save money on first aid kits by buying crap.
There is a difference between EMS shears and cheap plastic scissors (often seen in medical kits), and that difference can be the difference between life and death, just like reloading time with a weapon.
Do not write “check” on the medical kit list just because you have scissors or shears. You need to test them first, see what can you do with them.
Same goes with every other item in the first aid kit.
The specifics of a First Aid kit
A tough question is what you need to store in the medical field of prepping.
Well, it depends on many factors.
The first and most obvious is MONEY.
So, common sense says “store stuff that you know how to use”, but common says should say too that if you have enough money for more complicated things to own, then own it. You can trade part of that one day for knowledge (and work) from someone who knows how to use it.
The second thing, and it is again a thing of common sense is to store stuff that you will need.
So, for example, if you are having people in your family with chronic medical conditions it makes a lot of sense to store a LOT of medicines for that condition because you will need it for sure. No matter how much cool stuff you have in your medical stash if your husband has years of chronic high blood pressure that is what you are gonna need first – medication for it, and if is gonna be a prolonged SHTF you will need a lot of it.
Yes I know, there are natural remedies for a lot of chronic or not chronic medical conditions, but trust me – stash a lot of real medication and count on natural remedies just like additional help or last resort.
Common sense also says that you need to research a bit of the stuff that you store, not only to test it, but to research what is happening when you use it in a prolonged event. Because remember, you will not use something and hand off the patient to professional medical care.
You are immediate and prolonged medical care.
One example here and it is only an example are quick clotting agents like Quik Clot or Celox granules.
Now I am not saying they are bad – they are great actually. But they should be used ONLY when you can not stop the bleeding with any other means (or when you clearly see you can not stop it with any other means).
It is simply because often that wounds later need additional treatment in cleaning it for a very long time after.
So, do not use some stuff unless you really need it. Another example would be a tourniquet – do not use it if you can stop bleeding with other means, otherwise, you might get yourself and patient in real trouble because you are completely cutting off the blood supply to an extremity.
You must learn – really learn – about everything you have.
So it is common sense to learn everything about the things that you have. You need to take things out of packages and practice with them. You need live instruction.
Simple first aid manual that tells you how to use something usually is not enough, just like watching a 15-minutes video about shooting will not teach you a lot about shooting and armed conflict.
Selco survived the Balkan war of the 90s in a city under siege, without electricity, running water, or food distribution. He is currently accepting students for his next physical course here.
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There are two big statements mentioned here that I have not seen in any other article anywhere (not to say it isn’t out there, but I haven’t seen it.), so ahead of time, thanks to Selco for bringing up these points…
1) Mentioning that, in our current situation, there is ‘a system’ to hand a patient off to after you’ve performed your basic / advance first-aid is different than in a SHTF environment where you, by yourself or with a minimal amount of support, have to treat, transport, continue wound care / life support all the while with minimal supplies and access to advance medicine was spot on.
2) This is the only article I’ve seen regarding the use of quick clotting agents like Quik Clot or Celox granules with the brief instruction(s) that THEY MUST BE REMOVED (cleaned out) from the wound after the patient is brought to the ER or aid-station. You can not leave the granules in the wound during the healing period. That would be a clear path of rejection, leading to infection.
Although I do have several clotting “granule” products, I prefer the gauze / sponge products. Once the patient is in the safe and somewhat sterile environment of an ER / Aid-Station, it’s much easier and safer to remove a sponge or gauze than EACH individual granule of Celox, et al.
DO NOT use clotting granules (powder) if you do have the means to remove them once the patient is in a stabilized location.
( My medical experience is as follows: I was a Paramedic 30 plus years ago, on the streets of a large western city, long before any clotting type agents were available and I also assisted several times in our Firebase Aid-Station in Afghanistan early on in the war. I’m not a doctor, I’m not a nurse, I’m not even a paramedic anymore, but I do have a little medical experience under my belt and I do continue to research field medical techniques in austere environments.)
What Selco is saying is much like a medical book I bought last year titled ” Emergency Medicine for when help IS NOT on the way” . That is sound theory even if you say are on a backpack trip , 100 miles from any community, and no cell service . I have been in that circumstance and as an herbalist of more than 50 years I know that there is a lot of emergencies that just herbal medicine will not cover.
Learn all you can , it WILL mean the difference in life or death.
Very good advice. I worked in an Emergency Dept for 20 years and saw many examples of bad first aid. One that is appropriate for this article. Folks brought in a guy with a bad chain saw injury to his arm. He was literally leaving a trail of blood from the door to exam area. Pushed his sleeve up and saw a tourniquet, popped it off and most bleeding stopped. It was on tight enough to stop venous return but not arterial flow. Direct pressure worked nicely. Start with the simple and move up as appropriate- unless of course limb is almost off. Being able to remain calm is the most important thing to have in your kit.
Post injury care is the place most die from secondary infection. For a limb shot this will take approximated 300 pieces of gauze over its heal time. Not counting tape or anti biotic nor pain meds.
Everyone in your group need to be blood type tested/ disease tested. Direct iv is only way to save people in some situations.
Have surgical equipment for stiching and practice in bacon belly with skin on…. then tasty meal….. this time you can eat your mistakes and everyone is okay with it…. other time better not make one.
Learn to stitch blood vessels if you can specal tools needed. It not have super glue ready.
Celox can be flushed with a ton of saline…. this is going to cause more damage to wound site.
Gun shot wounds need to be de bride if excessI’ve loose meat in wound. There is a tool for that. And since deep muscle wound it will have to be drainage shunted. Pulling out a bullet is not like on tv. There are special tools and technique for it. Since you will no x ray or ultrasound. It is risky and life threatening. Better remember you circlitory class and hope not an exception to rule.
A gun shot currently consumes about 4 gram of medical heroin by end of treatment…. what do you have on stock?
If you have to do surgery what do you have to keep patient immobile? Not like movies where you can cut someone and they grit teeth after a swig of whiskey.
Burns are the worst to treat a ton of pain,infection and materials and it never heals back fully.
How much anti biotic a major injury is atleast 14 days 3 pills a day so 42 pills.
Does each of your group carry both a nasal and oral air way fitted for them in ifak?
Terrific article. Well stated.
I just realized that my SHTF first aid kits are designed for non-SHTF situations.
Thank you for this clear and sober sermon on first aid preparedness. I’ve got a lot of good stuff because of the knowledge of family members in the medical field. But I’ll been riding on prayer if I have to use it for really bad wounds. DH is a wise man but he faints at the sight of his own blood. Emotional triggers can’t be helped in the moment. So — keeping our wits — also has to be prepared for– perhaps more than all the rest.
Having a good cry for the future now may be a good investment in our wits. Seriously.
I took a NOLS Wilderness EMT course.
What you have in the wounded’s pack (always use their stuff first), and yours is what you have.
What do you have on hand to immobilize them? A broken arm? How to apply traction?
While preppers do put emphasis on bullet wounds, slip, trips and falls are mundane yet still the most common sources of injuries.
SELCO mentions the lack of full time medical support and the logistics that go along with a nation back military. You need to think of not only immediate care, but of long term, holistic care, to include recovery and physical therapy.
Wow brother you’re almost as bad as I am ranting and raving about something that you’re passionate about don’t get me wrong I agree with everything you said but just remember now that you’ve told them what not to do you need to tell ’em what they are supposed to do
1. Sterile gauze pads are relatively expensive.
2, You do not have enough gauze pads.
3. Non sterile gauze pads come in bulk packages and are inexpensive.
4. Buy lots of non sterile pads on Amazon or eBay and sterilize them yourself.
Wrap 10 pads in an aluminum foil envelope and fold the edges over several times. Bake in the oven at 350 or so for an hour or two. I’d trust the sterility, you be your own judge.
Amazon 200 pads for $12.00
eBat 200 pads for 5.65
Selco gives the best first hand advice. Thank you for another great article. My following advice I see with the upmost respect for Selco and his great points about long term or prolonged care. He is spot on! I do however have to debunk the Tourniquet myth and the advice he gives on Hemostatic Agents.
A Tourniquet should be an immediate action and the first step in hemorrhage control of the extremities. This can be in place for hours without limb loss. You will however die of Exsanguination in minutes if not controlled. Once the threats are neutralized or you are in a safe place, you can do a Tourniquet Conversion (wound pack and pressure) then release the tourniquet. This can be found in any TCCC or TECC guideline. Yes it’s tactical but the principle is the same for any hemorrhage.
As for Hemostatic impregnated gauze, Everything on the market today will not cause further problems if some is left in the wound (we should be learning how to clean and flush it anyway correct?) Your body can also metabolize them. The best choice for Preppers and anyone who might not get to definitive care immediately is ChitoGauze. ChitoGauze works independently of the body’s clotting cascade so if your Hypothermic , on blood thinners, or have a clotting disorder it will work. The other thing special to ChitoGauze is its antibacterial properties and your body’s ability to break it down completely (basically turns it to sugar).
I’ll end with the advice to stay away from the first generation of Quick Clot, and anything that is in granulated form.
My background is a Paramedic, Outdoor Emergency Care Provider, EMS educator, and a TCCC instructor.
I’ve read that common granulated sugar can be used in a pinch as a coagulant. Is that true, and does it eventually dissolve, and is it antimicrobial) which I’ve also heard?
As a former US Army trained (Ft Sam Houston) AMed Pilot this is the best article I have seen on foundational elements of a “First Aid Kit” and REALLY learning to use one when no help is on the way and may not be for a long while. I live in Asia for now and the federal government here is corrupt and incompetent.
Prone to natural disasters you better have your SHTF together. A weapon is not my first line of defense. Fresh water, shelter, food and a PROPER First Aid Kit with prescriptions and safety gear is. Looting and STRANGER DANGER will begin when the masses cannot find food.
I know this might not be exactly what you would call a comment but I’ve been wanting to ask you if you think they will ever make One Second After into a movie? Do you think we would pick it to death about the details and correct ways of doing things. As much as the book changed my life, I think the movie would reach many more. Do you think they could do the book justice? Have you heard anything about them making it into a movie?
Loved the article Selco. I just nodded my head when you said every item needs to used. We did a burn gel practice run and there was that “one guy” who had to look at the watery mixture and asked “Do I have to touch it?” Cool I get it, not all the children ate dirt and drank from a hose. The other 13 of us applied and had applied the product. Messy, yes but I know it is hard as heck to place them sometimes. Great article!
I’ve worked in and around EMS throughout my undergraduate studies. EMS and current urban EMT/paramedic training is designed to rely on the established system to treat patients and initiate interventions. There is some basic wound care, but emphasis is placed on acute illness and trauma – the types of things that are death sentences in any grid down scenario. The best medical training I’ve had yet is NOLS Wilderness First certification. It’s emphasis is prevention, which is key in any survival situation. It further elaborates on wound management and patient management for long periods of time when no help is coming. Reducing dislocations and certain fractures are also covered, as well as environmental situations. As mentioned, most people neglect their first aid skills and kits, and settle for “band-aid” packs from amazon or Walmart. Take some time and money to put together a quality kit that emphasizes wound management, cleaning, and other moderate interventions. Anything more and you’d need to probably take your patient to a doctor. Knowing first aid skills and other more advanced wound care techniques, along with the right technology in a kit, can be a game changer in survival. You can treat yourself, your family/group, and offer skills to other groups in exchange for things. It’s a niche that even most modern medical people will be at-a-loss when their fancy toys are kaput.